Experience with 120 synthetic hydroxyapatite implants (FCI3)

PURPOSE: To assess the problems and/or complications associated with the use of a synthetic hydroxyapatite implant (FCI, Cedex, France). METHODS: The authors analyzed all of the problems and/or complications associated with the use of a third-generation synthetic hydroxyapatite implant (FCI3) in 120 patients by one surgeon over 4 years. The following data were recorded: age, type of surgery performed, size of implant used, peg system used, follow-up duration, time of pegging, problems and/or complications encountered, and treatment. RESULTS: Thirteen patients were lost to follow-up after 3 months, leaving 107 patients who were followed up from 4 to 48 months (average, 29 months). Discharge occurred in 21 (19.6%) patients, implant exposure in 3 (2.8%), socket discomfort in 2 (1.9%), trochleitis in 2 (1.9%), conjunctival thinning in 1 (0.93%), and pyogenic granuloma in 1 (0.93%). Peg problems occurred in 24 (35.2%) of 68 patients. Problems encountered with the peg were discharge in 10 (14.7%) patients, pyogenic granuloma in 9 (13.2%), conjunctiva overgrowing the peg in 4 (5.8%), hydroxyapatite exposure around the sleeve in 3 (4.4%), loose sleeve in 3 (4.4%), peg drilled on an angle in 1 (1.5%), implant infection in 1 (1.5%), and peg falling out in 1 (1.5%). CONCLUSIONS: The FCI3 synthetic hydroxyapatite is a less costly alternative form of hydroxyapatite currently in use in many parts of the world. Problems and complications encountered with its use are similar to those seen with the Bio-Eye Integrated Orbital Implants, Inc., San Diego, CA, U.S.A. The incidence of exposure associated with the synthetic hydroxyapatite implant is lower than several other reports on the Bio-Eye. The synthetic hydroxyapatite implant is slightly softer than the Bio-Eye and fractured under extreme pressure in one case.